Lower quality of life in obese ICU survivors: a multicenter cohort study.

PURPOSE: To compare health-related quality of life (HRQoL) and functional status between obese, underweight, normal-weight, and overweight patients after three months post-intensive care unit (ICU) discharge. METHODS: Multicenter cohort study (10 Brazilian ICUs). 1600 ICU survivors (≥ 72 h in the ICU) were included.The main outcomes were HRQoL and functional status assessed three months after the ICU discharge. The secondary outcomes were mortality, hospital readmission, and ICU readmission during the same period. RESULTS: Obese patients (median 50.1; IQR 39.6-59.6) had lower HRQoL in the mental component than normal-weight patients (median 53; IQR 45.6-60.1) (p = 0.033). No differences were found between BMI categories regarding the physical component of HRQoL and the Barthel Index (p = 0.355 and 0.295, respectively). Regarding readmissions, 65.1 and 25.1% of patients were readmitted to the hospital and ICU, but there was no difference between the groups (p = 0.870 and 0.220, respectively). Obese patients died less frequently (11.8%) than underweight (30.9%) and normal-weight (19.3%) patients (p < 0.001). CONCLUSION: After three months of post-ICU discharge, obese patients had lower HRQoL in the mental component than normal-weight patients. However, obese patients died less than underweight and normal-weight patients.

Statin Use Improves Cardiometabolic Protection Promoted By Physical Training in an Aquatic Environment: A Randomized Clinical Trial. / Uso de Estatinas Melhora a Proteção Cardiometabólica Promovida pelo Treinamento Físico em Ambiente Aquático: Um Ensaio Clínico Randomizado.

BACKGROUND: Statin use is highlighted as the most commonly utilized therapy for the treatment of dyslipidemias and can be considered as the most efficient pharmacological intervention for low-density lipoprotein (LDL) reduction. On the other hand, physical training can be considered an efficient and safe non-pharmacological strategy to promote improvements in lipid profile. However, the influence of statins on lipid adaptations arising from water-based training in populations with dyslipidemia is not known. OBJECTIVES: To analyze the influence of simvastatin use on lipid adaptations arising from water-based aerobics and resistance training in elderly women with dyslipidemia. METHODS: Sixty-nine elderly (66.13 ± 5.13 years), sedentary, and dyslipidemic women, both non-users and users of simvastatin (20 mg and 40 mg), were randomized into the following 3 groups: water-based aerobic training (WA), water-based resistance training (WR), and control group (CG). Total duration of interventions, for all experimental groups consisted of 10 weeks, with 2 weekly sessions. Biochemical analyses were performed before the beginning of the interventions and repeated after the end of the trial. Generalized estimating equations were used to compare these data, setting α = 0.05. RESULTS: In intention-to-treat analysis, the medicated participants obtained a greater magnitude of decrease in total cholesterol (TC) (-3.41 to -25.89 mg.dl-1; p = 0.038), LDL (-5.58 to -25.18 mg.dl-1; p = 0.007) and TC/HDL ratio (-0.37 to -0.61; p = 0.022) when compared to the non-medicated participants, and this decrease was statistically significant only in the WR group. CONCLUSIONS: Statin use enhances the adaptations promoted by water-based physical training in CT, LDL levels, and CT/HDL ratio, and it is more pronounced after WR.

FUNDAMENTO: O uso de estatinas destaca-se como a terapia mais frequentemente utilizada para o tratamento de dislipidemias e pode ser considerado a intervenção farmacológica mais eficiente para a redução da lipoproteína de baixa densidade (LDL). Por outro lado, o treinamento físico pode ser considerado uma estratégia não farmacológica eficiente e segura para promover melhorias no perfil lipídico. No entanto, não se sabe qual seria a influência das estatinas nas adaptações lipídicas decorrentes do treinamento aquático em populações com dislipidemia. OBJETIVOS: Analisar a influência do uso de sinvastatina nas adaptações lipídicas decorrentes do treinamento aeróbico em meio aquático e de resistência em mulheres idosas com dislipidemia. MÉTODOS: Sessenta e nove mulheres idosas (66,13 ± 5,13 anos), sedentárias e dislipidêmicas, tanto não usuárias quanto usuárias de sinvastatina (20 mg e 40 mg), foram randomizadas nos 3 grupos seguintes: treinamento aeróbico em meio aquático (WA), treinamento de força em meio aquático (WR) e grupo controle (GC). A duração total das intervenções, para todos os grupos experimentais, foi de 10 semanas, com 2 sessões semanais. As análises bioquímicas foram realizadas antes do início das intervenções e repetidas após o final do ensaio. Foram utilizadas equações de estimativa generalizada para comparar esses dados, estabelecendo α = 0,05. RESULTADOS: Na análise por intenção de tratar, as participantes medicadas demonstraram uma redução de magnitude maior do colesterol total (CT) (−3,41 a −25,89 mg.dl−1; p = 0,038), LDL (−5,58 a −25,18 mg.dl−1; p = 0,007) e da relação CT/HDL (−0,37 a −0,61; p = 0,022) quando comparadas às participantes não medicadas, essa redução sendo estatisticamente significativa apenas no grupo WR. CONCLUSÕES: O uso de estatina incrementa as adaptações promovidas pelo treinamento físico aquático no CT, nos níveis de LDL e na relação CT/HDL, sendo mais pronunciado após WR.

Pilates training improves aerobic capacity, but not lipid or lipoprotein levels in elderly women with dyslipidemia: A controlled trial.

INTRODUCTION: The aim of the present study was to verify the effects of a Pilates training on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose and C-reactive protein (CRP) levels, as well as on functionality of postmenopausal women with dyslipidemia. METHOD: This randomized study involved 35 sedentary women with dyslipidemia, aged between 60 and 75 years. One group participated in a Pilates exercises training with two to four weekly sessions during 10 weeks (Pilates group, n = 20) and the other group did not perform any intervention (control group, n = 6). Biochemical analyses and functionality parameters were measured before and after the 10 weeks. RESULTS: No significant differences were observed in TC, TG, LDL and HDL for both groups. Regarding glucose and CRP levels, significant reductions were observed in both groups after the intervention period. In functional parameters, both groups significantly increased their 30-s chair stand test values. On the other hand, only the Pilates group presented significant increments in the 6-min walk test (p < 0.05). CONCLUSION: Pilates training did not change lipid or lipoprotein levels, but improved cardiorespiratory fitness of elderly women with dyslipidemia.

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status.

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81-48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Effect of Strength Training on Lipid and Inflammatory Outcomes: Systematic Review With Meta-Analysis and Meta-Regression.

Background: The aim of this study was to perform a systematic review with meta-analysis and meta-regressions evaluating the effects of isolated strength training (ST), compared with a control group, on total cholesterol (TC), triglycerides (TG), low-density (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP), and adiponectin of adults. Methods: Embase, PubMed, Cochrane, and Scopus data sources were searched up to May 2017. Clinical trials that compared ST with a control group of adults older than 18 years, which evaluated blood TC, TG, LDL, HDL, CRP, or adiponectin as an outcome were included. Random effect was used and the effect size (ES) was calculated by using the standardized mean difference with a 95% confidence interval. Results: ST promotes a reduction in TC (ES: -0.399; P < .001), TG (ES: -0.204; P = .002), LDL (ES: -0.451; P < .001), and CRP (ES: -0.542; P = .01) levels. In addition, ST is associated to an increase in HDL (ES: 0.363; P < .001) and adiponectin concentrations (ES: 1.105; P = .01). Conclusion: ST promotes decreases in TC, TG, LDL, and CRP levels and increases HDL and adiponectin concentrations. Thus, progressive ST could be a potential therapeutic option for improving abnormalities in lipid and inflammatory outcomes in adults.

Water-Based Aerobic Training Successfully Improves Lipid Profile of Dyslipidemic Women: A Randomized Controlled Trial.

PURPOSE: This study aimed to investigate the effects of water-based aerobic training on the lipid profile and lipoprotein lipase (LPL) levels in premenopausal women with dyslipidemia. METHOD: Forty women were randomly assigned to: aquatic training (WA; n = 20) or a control group (CG; n = 20). The WA group underwent 12 weeks of water-based interval aerobic training twice a week at intensities ranging from 9 to 15 on the Borg Scale of Perceived Exertion. Total cholesterol (TC), triglycerides (TG), high- (HDL) and low- (LDL) density lipoprotein, TC/HDL ratio, LPL levels, and peak oxygen consumption (VO2peak) were evaluated before and after 12 weeks in both groups. RESULTS: The WA group elicited decreases in TC (9%; effect size [ES] = 0.69; 95% CI [0.05, 1.33]), LDL (16%; ES = 0.78; 95% CI [0.13, 1.42]), and the TC/HDL ratio (17%; ES = 1.13; 95% CI [0.46, 1.79]), as well as increases in VO2peak (10%; ES = 0.64; 95% CI [0.002, 1.27]) and HDL (10%; ES = 0.28; 95% CI [-0.35. 0.90]), without significant changes in TG (ES = 0.16; 95% CI [-0.46, 1.79]) and LPL (ES = 0.36; 95% CI [-0.27, 0.98]) levels. In the CG, no statistically significant changes in any of these variables were found (TC, ES = 0.19, 95% CI [-0.43, 0.82]; LDL, ES = 0.22, 95% CI [-0.40, 0.85]; HDL, ES = 0.05, 95% CI [-0.57, 0.67]; TG, ES = 0.09, 95% CI [-0.53, 0.71]; TC/HDL ratio, ES = 0.20, 95% CI [-0.42, 0.82]; LPL, ES = 0.02, 95% CI [-0.60, 0.64]; VO2peak, ES = 0.20, 95% CI [-0.42, 0.82]). CONCLUSION: Water-based interval aerobic training positively affected the lipid profile in premenopausal dyslipidemic women.

Water-based aerobic training improves strength parameters and cardiorespiratory outcomes in elderly women.

The aim of the present study was to compare the effects of water-based aerobic training and water-based resistance training on muscular strength and cardiorespiratory fitness in older women. Sixty-nine individuals were randomized into the following three groups: the water-based aerobic training (WA, n = 23) group, the water-based resistance training (WR, n = 23) group, and the control group (CG, n = 23). Participants were trained two times per week for 10 weeks. The trainings presented a linear periodization with an increase in the volume-intensity relation. Maximal dynamic muscular strength and the cardiorespiratory fitness were evaluated before the start of training and after 10 weeks of training. Only the WA group showed an increase in maximal oxygen consumption (13.8%) and oxygen consumption at the second ventilatory threshold (16.4%). Maximal dynamic strength of knee extensors improved in 10.6% of WA, 8.0% of WR, and 4.7% of CG participants, without any difference between the groups. Maximal dynamic strength of knee flexors was increased in 14.1% of WA and in 17.7% of WR participants; however, it remains unchanged in CG participants. No differences were observed in resting heart rate, peak heart rate, heart rate at the second ventilatory threshold and maximal dynamic strength of shoulder horizontal flexors. It was concluded that WA seems to be more efficient for improvement in cardiorespiratory responses, and both WA and WR were efficient for development of maximal dynamic strength of knee flexion and extension.

Short-term water-based aerobic training promotes improvements in aerobic conditioning parameters of mature women.

Aging is accompanied by a decrease in aerobic capacity. Therefore, physical training has been recommended to soften the effects of advancement age. The aim of this study was to assess the effects of a short-term water-based aerobic training on resting heart rate (HRrest), heart rate corresponding to anaerobic threshold (HRAT), peak heart rate (HRpeak), percentage value of HRAT in relation to HRpeak and test duration (TD) of mature women. Twenty-two women (65.91 ± 4.83 years) were submitted to a five-week water-based interval aerobic training. Aerobic capacity parameters were evaluated through an aquatic incremental test. After training, there was an increase in TD (16%) and HRAT percentage in relation to HRpeak (4.68%), and a reduction of HRrest (9%). It is concluded that a water-based aerobic interval training prescribed through HRAT of only five weeks is able to promote improvements in aerobic capacity of mature women.

Uso de estatinas melhora a proteção cardiometabólica promovida pelo treinamento físico em ambiente aquático: Um ensaio clínico randomizado / Statin use improves cardiometabolic protection promoted by physical training in an aquatic environment: A Randomized Clinical Trial

Resumo Fundamento: O uso de estatinas destaca-se como a terapia mais frequentemente utilizada para o tratamento de dislipidemias e pode ser considerado a intervenção farmacológica mais eficiente para a redução da lipoproteína de baixa densidade (LDL). Por outro lado, o treinamento físico pode ser considerado uma estratégia não farmacológica eficiente e segura para promover melhorias no perfil lipídico. No entanto, não se sabe qual seria a influência das estatinas nas adaptações lipídicas decorrentes do treinamento aquático em populações com dislipidemia. Objetivos: Analisar a influência do uso de sinvastatina nas adaptações lipídicas decorrentes do treinamento aeróbico em meio aquático e de resistência em mulheres idosas com dislipidemia. Métodos: Sessenta e nove mulheres idosas (66,13 ± 5,13 anos), sedentárias e dislipidêmicas, tanto não usuárias quanto usuárias de sinvastatina (20 mg e 40 mg), foram randomizadas nos 3 grupos seguintes: treinamento aeróbico em meio aquático (WA), treinamento de força em meio aquático (WR) e grupo controle (GC). A duração total das intervenções, para todos os grupos experimentais, foi de 10 semanas, com 2 sessões semanais. As análises bioquímicas foram realizadas antes do início das intervenções e repetidas após o final do ensaio. Foram utilizadas equações de estimativa generalizada para comparar esses dados, estabelecendo α = 0,05. Resultados: Na análise por intenção de tratar, as participantes medicadas demonstraram uma redução de magnitude maior do colesterol total (CT) (−3,41 a −25,89 mg.dl−1; p = 0,038), LDL (−5,58 a −25,18 mg.dl−1; p = 0,007) e da relação CT/HDL (−0,37 a −0,61; p = 0,022) quando comparadas às participantes não medicadas, essa redução sendo estatisticamente significativa apenas no grupo WR. Conclusões: O uso de estatina incrementa as adaptações promovidas pelo treinamento físico aquático no CT, nos níveis de LDL e na relação CT/HDL, sendo mais pronunciado após WR.

Abstract Background: Statin use is highlighted as the most commonly utilized therapy for the treatment of dyslipidemias and can be considered as the most efficient pharmacological intervention for low-density lipoprotein (LDL) reduction. On the other hand, physical training can be considered an efficient and safe non-pharmacological strategy to promote improvements in lipid profile. However, the influence of statins on lipid adaptations arising from water-based training in populations with dyslipidemia is not known. Objectives: To analyze the influence of simvastatin use on lipid adaptations arising from water-based aerobics and resistance training in elderly women with dyslipidemia. Methods: Sixty-nine elderly (66.13 ± 5.13 years), sedentary, and dyslipidemic women, both non-users and users of simvastatin (20 mg and 40 mg), were randomized into the following 3 groups: water-based aerobic training (WA), water-based resistance training (WR), and control group (CG). Total duration of interventions, for all experimental groups consisted of 10 weeks, with 2 weekly sessions. Biochemical analyses were performed before the beginning of the interventions and repeated after the end of the trial. Generalized estimating equations were used to compare these data, setting α = 0.05. Results: In intention-to-treat analysis, the medicated participants obtained a greater magnitude of decrease in total cholesterol (TC) (−3.41 to −25.89 mg.dl−1; p = 0.038), LDL (−5.58 to −25.18 mg.dl−1; p = 0.007) and TC/HDL ratio (−0.37 to −0.61; p = 0.022) when compared to the non-medicated participants, and this decrease was statistically significant only in the WR group. Conclusions: Statin use enhances the adaptations promoted by water-based physical training in CT, LDL levels, and CT/HDL ratio, and it is more pronounced after WR.

Effects of Single Vs. Multiple Sets Water-Based Resistance Training on Maximal Dynamic Strength in Young Men.

The aim of this study was to compare the effects of single vs. multiple sets water-based resistance training on maximal dynamic strength in young men. Twenty-one physically active young men were randomly allocated into 2 groups: a single set group (SS, n=10) and a multiple sets group (MS, n=11). The single set program consisted of only 1 set of 30 s, whereas the multiple sets comprised 3 sets of 30 s (rest interval between sets equaled 1 min 30 s). All the water-based resistance exercises were performed at maximal effort and both groups trained twice a week for 10 weeks. Upper (bilateral elbow flexors and bilateral elbow extensors, peck deck and inverse peck deck) as well as lower-body (bilateral knee flexors and unilateral knee extensors) one-repetition maximal tests (1RM) were used to assess changes in muscle strength. The training-related effects were assessed using repeated measures two-way ANOVA (α=5%). Both SS and MS groups increased the upper and lower-body 1RM, with no differences between groups. Therefore, these data show that the maximal dynamic strength significantly increases in young men after 10 weeks of training in an aquatic environment, although the improvement in the strength levels is independent of the number of sets performed.

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81−48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.